Treatment of Motor Function and Balance- A New Tool

运动功能和平衡治疗——一种新工具

• 批准号: 7140323
• 负责人: LARS I E ODDSSON
• 金额: $ 13.56万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140323
• 关键词: Parkinson' s disease; assistive device /technology; balance; biomedical equipment development; body weight; clinical research; gait; human subject; musculoskeletal disorder therapy; nervous system disorder therapy; neuromuscular system; performance; posture; psychomotor function; rehabilitation

DESCRIPTION (provided by applicant): This is an R21 proposal in direct response to the announcement PA-04-006, "Neurotechnology, Research, Development, and Enhancement". This proposal addresses the request in the PA related to "development of novel tools and approaches for the study of the development, structure and function of the brain" including "those used for clinical assessment, diagnosis and treatment of brain disorders". As stated under "SPECIAL REQUIREMENTS" in the announcement, applications "may be design-, problem-, need-, or hypothesis-driven ". The current proposal is driven by the need for tools that can provide early effective and functional treatment of several categories of patients e.g. those with spinal cord and brain injuries including stroke as well as neurological diseases such as Parkinsonism. Furthermore, hip fractures, a common consequence of falls, seriously affect mobility and often leads to early death, especially in the elderly population. Current research has demonstrated in these populations of patients that gait training using partial body weight support (BWS) on a treadmill improves walking better than training with full weight bearing. One problem with the BWS technique that is not commonly acknowledged is that the harness supporting the subject decreases the need for a natural postural control. The harness provides an external support partly eliminating associated postural adjustments that are required during independent gait. We propose to build a tool that can further refine the concept of BWS training by allowing natural associated postural adjustments directly in the BWS training. We have demonstrated that upright balance function improves after training in a 90 deg tilted visual environment with the subject in a supine position strapped to a device (freely moving on air-bearings, cf. puck on an air hockey table) with a G-like load provided by a weight stack. For movements in the frontal plane, the tilted room environment allows associated postural adjustments, required in an upright environment, to occur. A video of a subject exercising in this environment appears to a blinded viewer as being upright with normal frontal plane postural adjustments and balancing against gravity. We propose to design, build and test a portable version of the tilted room concept that can be used in a hospital/clinical setting. Instead of a physical room subjects will view two 3-D automultiscopic displays representing windows to a virtual environment that may be captured from sites decided by the patient. In addition to treatment, the device can be used as a research tool to study postural control mechanisms The investigators represent a multidisciplinary team of experts from biomedical, computer engineering and the rehabilitation and exercise sciences.

描述（由申请人提供）：这是一项 R21 提案，直接响应公告 PA-04-006“神经技术、研究、开发和增强”。该提案满足了 PA 中有关“开发用于研究大脑发育、结构和功能的新工具和方法”的要求，包括“用于临床评估、诊断和治疗大脑疾病的工具和方法”。正如公告中“特殊要求”所述，应用程序“可能是设计、问题、需求或假设驱动的”。目前的提议是由于需要能够为几类患者提供早期有效和功能性治疗的工具，例如：患有脊髓和脑损伤（包括中风）以及帕金森氏症等神经系统疾病的人。此外，髋部骨折是跌倒的常见后果，严重影响活动能力并常常导致过早死亡，特别是在老年人群中。目前的研究表明，在这些患者群体中，在跑步机上使用部分体重支撑 (BWS) 的步态训练比完全负重训练更能改善步行。 BWS 技术的一个未被普遍承认的问题是支撑受试者的安全带减少了对自然姿势控制的需求。该安全带提供了外部支撑，部分消除了独立步态所需的相关姿势调整。我们建议构建一个工具，通过允许直接在 BWS 训练中进行自然相关的姿势调整，可以进一步完善 BWS 训练的概念。我们已经证明，在 90 度倾斜的视觉环境中进行训练后，直立平衡功能会得到改善，受试者处于仰卧位置，并绑在带有 G 型装置的设备上（在空气轴承上自由移动，参见空气曲棍球桌上的冰球）由配重片提供的负载。对于额状面的运动，倾斜的房间环境允许进行直立环境中所需的相关姿势调整。在这种环境中锻炼的受试者的视频在失明的观看者看来是直立的，具有正常的额面姿势调整和对抗重力的平衡。我们建议设计、构建和测试可在医院/临床环境中使用的倾斜房间概念的便携式版本。受试者将观看两个 3D 自动多视场显示器，而不是物理房间，它们代表虚拟环境的窗口，该虚拟环境可以从患者决定的地点捕获。除了治疗之外，该设备还可以用作研究姿势控制机制的研究工具。研究人员代表了来自生物医学、计算机工程以及康复和运动科学的多学科专家团队。